12632 SW SORREL DOCK COURT •jM1
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CITYOF716ARD
MECHANICAL
CRY �� PERMIT
COMMUNRY DEVELOPMENT DEPARTMENT MOM PERMIT #. . . . . . . : MEC91-0232
19125 SW AW1 SMd. P.O.BoK 29:!07,T10ordr Oropwi 07229(S09)5I"i 75
sin ADDRESS. . . : 12632 SW SORREL DOCK. CT PARCEL: 1S1 33A-D 150
10 SUDDIVISION. . . . SUMME..RLAKE ZONING: R-7 PD �
Bi.-OCK. . . . . . . . . . : LOT. . . . . . . . . . . . . 131
CLASS OF' WORK. . :ADD rLJAOR FURN. . . . r EVAP COOLERS:
TYPE OF USE. . . . :SF UN IT HEATERS. . : VL:-.NT FANS. . . :
OCCUPANCY GRP. . :R VENTS W/O APDL: VENT SYSTEMS:
STORIES. . . . . . . . : c BOI1-ERS/GOMPPF-_SSOR5 HOODS. . . . . . . :
FULL T VF'CS---_-_-- -- 0-3 HP. . . . : DOMES. I NC I N:
: /ELF/ / -15 HP. . . . . 1 COMML. INCIN:
MAX INPUT: PTU 15-30 HP. . . . : REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 HP. . . . : WOODSTOVES. . :
6AS PRESSURE. . . : 50+ HF.. . . . . CLO DRYERS. . :
NO. OF UNITS----------- AIR HANDLING UNITS OTHER NITS. :
TURN ( 100K BTL': (= 10000 cfm : GAS OUTLETS. :
FURN > =100K B1'U: ) 10000 r_fm ;
Hemarles : 1NSTALL 3. 5 ION AIR CONDITIONER
Owner, , --------------------------------------- _..__.___-._...._-----.-_-_-•- FEES
(,HII-LIF, MCCOLL.ISTER type amour t by date ►•ecpt
12632 ,SIJ SORREL DOCK CT PRMT $ 25. 00 ,TI_fl 10/07/91
5F'CT $ 1. 50 ,TLH 10/07/91 -
TIGARD OR 97223 l
Phone #:
1
Contractor: --•---_.-_.----- -----_____._---__-_--
BELL HEATING INC
15550 SE PIAllA AVE
CLACKMAS OR 9701 -•----- ----_.._______.-_----_-.-•-- __.____.
Phone #: 243-1184 $ 26. 50 TOTAI-
[Reg #. . : 447
------- REPUIRED INSPECTIONS
This permit is issued subject .ne regulation. contained in the Final Inspection
Tigard Muniripal Code, State 0 Ore. Srecialty Codes and all other
applicabie laws. ^ll work will be aone in accordance with
aor;oved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
ban 180 days.
Permittee SiynLAt1.1r,ei�
Iss�.led By:
Cell for inspection - 639-4175
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&PECTiON NO'1_iCE
City of Tigard Building Dec3artoent
13125 SW Ball Blvd. 'Tigard, Oregon 97223
Inspection Line (Rec-4-Phone)t 619-4175 Jusiness Phone: 639-4171
Inspections ---
1 Footing Plbg. Unclerslab (,4ech. Rough-i� Appr/8iwlk
Foand. Plbg. T j, Out Gas Line FINA1.1
Post/Beam Struct. Snn. Sewer Framing -Bldg.
Pout/Beam Mach. Rn!n ;wain Insulation -Plumb. 0
Plbq. Undarf).00r NatOL Lino Gyp. Bu •'tech•
Date Requested _) 'l _1 ( —Tm= Am----.=Z--\PH
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'IT,
P.rz "L
Buillertlf�1. `Q M '+
TEM FOLLOWING r�ORREc"IONS ARE RBQUIREDt
tnspertor:_ Date: —
—_APPROVED DISAPPROVRD _ _ APPROVED SUBJRCT TO ABOVE
Call For Reinap.
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CII`Y OF TIGARD � r�
OREGONk
0,w-ner: CON MORISSETTE Perm+t No. 890176
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address: BOX 19524, PORTLAND, OR 97219
a :
Building Address: 12632 SW SORREL DOCK COURT
,41 _ Oceupane; R3 Land Use Zone:R-7(PD) Bldg. Type VN 1
i
�� -}• Comments:
18 89
Certificate is hereby given this 16TH day of JUNE ,
l
that said building may be occupied and tha it complies with al.
' requirements of the Building Code for the City of Tigard, as approved
by the Tigard City Council. :
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Fire Dept. Building I eet
.r •moi _ 1 �j
Building Oficial '
( L
Post Certificate in Conspicuous Place
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,�„' .u }�r• ,.. i R,,.,r�� rr..'�� ,�. .r -y .e mow.-. � ,r• ....Ms. .,,,I .i�r. M'e,,�, � ,,.�..,,�..,...t ;�1.,"a wfM''Mrr ew v
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IN,FHCTIAN WTIEE
j City of Tigard building Department
f P.O. Box 23397 r
'Tigard, Oregon 97223
Phone: 639-4175
Type of Inspection
Date Requ9sted_lam_- — Time A.M. P.M.
Address —
Owner
ddress _.-Owner
3 lot #__
_,__ --Builder ��•-- -------- --
Thc f-Mov,oing Building Code deficiencies are required to be corrected:
Presented to — lJ Approved
Inspector _—. ❑ Disapproved
Date
CALL FOR REINSPECTION
F-1YES EqINO
i rr�e;•z:;r
0
— ww
4 ? .
INSPECTION NOTICE
City of Tigard Building Department
P O. Box 23397 (/ -
Tigard, Oregon 97223 ..
Phone: 639-4175
11
Type of Inspection -- I
Date Requested � � z z --� Time A.M. P.M. ,
Address � V LY Permit #
Owner — Lot #
Builder \ I I l-"CC --) --- ----
The following Building Code deficiencies are required to be corrected:
-- — -----
Presented to. I I Approved
Inspectcr fir. I I Disapproved
Date
CALL FOR REINSPECTION
❑ YES NO '
hl'{�11H301YLF'1..Y{T<IWF.IN+"'.'.':bbl TMr::l:if ':.:Y. + Mt.M•';•. t.r.vx..n....... ..-...,.-..W.+w.rTreM�vWNMi.a.w./1R`
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INSPECTION NOTICE
City of Tigard Building Department
P.O. BoA 23397
+ice
Tigard, Oregon 97223
Phone:6394175
Type of Inspection f . C l ,R 51-C T—
Date Requested
/ /- Time-�-A.M. P.M.
Address h �_ �C�',Y j� iC Permit #
Lot
BuWill
ers \ 1 l(,Y h IN r
The following Building Code deficiencies are required •o be corrected:
Presented to J — L1 Approved
Inspector ❑ Disapproved
Date 9'
CALL FOR REINSPECTION
❑ YES ❑ NO
z�A {`�
x"o t
s
i
v
6
�rNPMt r"'AM+1,. .r . x•✓Y.tiM-.....�;'�M."N' .. '-a v.fW. .. ;=w'e.4M7}. ` �� i r
f�
INSPECTION NOTICE
City of Tigard Duilding Department
P.O. Box 23397
Tigard, Oregon 97223 v _
Phone: 639-4175 r
Type of Inspection
Date Requested '_ �7 Thne A.M. P.M.
Address 1 .� '-3 -��" Y..�•`C.L lam- Parmit .L 17.
Owner ` Lot #
Builder
The fol!owing Building Code deficiencies are required to be corrected:
Liz
Presented to ❑ Approved
Inspector Disapproved
Date v -f, -• A
CALL FOR REINSPECTION
2 ' IES ❑ NO '
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iu•tfp!•
• l
jtl�,�kYJIVME�'/YM14Y�N�FMWIAIYMrawwwMgwrw.....wwni.rv...s.+...-
j INSPECTION NOTICE.
It
City of Tigard BGilding Department
P O. Box 23397 I I'
Tigard, Oregon 97223
Pnone: 639-4175
t
Type of Inspection _—
�
C
Date Requested �,~ ' / Time Y_A.M. q P.M. O
AJdress �r'. 1 C� Permit
Owner . Lot #
Builder � � 1 J � UY LLd
The f,)llowing Building Code deficiencies are required to be corrected:
e--
Presented tor❑ Approved
14
Inspector 5isapproQeo
Date Z' 2 —
CALL FORREINSPECTION
YES ❑ NO
"li� AC�Mtl!wc+�wM' ..NMnryrygnaui+r. !1� IYilY4ild
IN;PECTION NOTICE n
City of Tiyard Building Department
P.O. Box 23397
Tigard. Oregon 97223
Phone. 639-4175
Type of Inspection
Date Requested Ttrt»C C� �� A.M. P.M.
Address —�'��. c= G�� ( C L( K Permit #.S (✓/C
Owner Lot #_
Builder
The following Building Code deficiencies are required to be corrected: f
i
6fde4ao A!
Presented to Approved
Inspector _. I i Disapproved
Date __y�•�C�� _
CALL ,FGRREINSPECTION '
ly7/YES r7 NO
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!�
..' .- ..Y .y 21 Kµ.WP ►4. .n .w.,w ..mow.,
+a'
..........................
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397 �" L
Tigard, Oregon 97223
Phone. 639-4175
Type of Inspection
I
Date Requested-_ 71me k A.M. P.M.
/'1Y (Y—
Address
Permit *—LZy
Owner Lot #
Builder
k
The following Building Code deficiP;icies are required to be corrected:
Presented to a _ --_ Approved
Inspector Disapproved
Date
CALL FOR REINSPECTION
❑ YE8 ❑ NO
,ga,cr 4iya.
i
A
INSPECTION NOTICE
Jity of I Igard Building Department Ci I
'.O. Pox 23397 �
Tigaid. Oregon 97223
Pho +: 639-4175
_ -�,r ,� "r Cis
Cis PQM
Type of Inspection _ `
Date Requested Time A.M. P.M.
i (� 3 �- G> r��.f L� O
Address, cy Permit #
Owner . Lot #
Builder
The following Buildinq Coo@ deficiencies are required to be corrected:
i
T
Pretented to 1
❑ Approved
Inspector [] Disapproved
Date
jCALL R REINSPECTION
❑ YES ❑ NO
•
INSPECTION NOTICE
City of Tigard Building Department /�In
�l
P.O. Box 23397 ( f
'i!gard, Oregon 97223
Phone: 8739-4175 /
Type of Inspection _
Date Requested 3 z bc
Time Lc.t� A.M. P.M.
Address 1 (c: 3 z _ y�SY)' (� c,k Permit #�b�U 17 L
Owr` ' Lot # _
Builder
The following Building Code deficiencies are required to be corrected:
Presented to
7-- -- Q'•4pproved
Inspector /
❑ Disapproved
Date
CALL FOR REINSPECTION
❑ YES ❑ NO
N'
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I
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CIIYOFTIFARD �, IF)E:raM1:T NCJ . : Elul�9nl rb
(CC— r.�alm �
COMMLIWTY DEVELOPMENT DEPARTMENT �
13125 S.W.H111 Blvd.,P.O.Box 23397,Tigard,Omy,,.97223.(5113)63944T5 :): T M DMV Will :(AQ 1"1 ty
)(:)1:3 ADDP'Ii*SS : 126.32 SW S01:4iE:I... DUCK (:'T'
' (AX MAF)/1...0'T I.S 1. 3 3AU .x.5000 GOP :: SUMMI11:41...AI(IF l-1iC :
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i ,eNr1 .14' R'�Pr.)
I..fTT r,1 ZE : VAI_.11AI IT : tq <�:'.i ,ODU SEA E3AC:KS
F�R(:lN T' : F'_0 REAR : I
WIJrZK C'11 AS( : NF W DWIF.A.I.. .ON 1'!a : :L L.E"F'1' : `i'
USE' '1 YPE: : SIM(Il E:: [:'AMY L Y N(:). IJL::I.)-40OMS : el I�:X 1' .W611..L. CONST :
CONS T TYNE:.: VN NO . HA11•d!; : �3 N: !� : F: : W: r
OC:C.'l IN G)RP.
OCZUP L JJAD N: a : 1::: : W: 1
01 AL. APPA: 01.*70 1
N(:l. !37'(:IP,rE r] 1050 61OOFF (.",UNrS T : C FJ E: PET? I
HE.:GH' ii'O ;'NI) 1 'I.RO AREA !:E PAP7 RATED
1:3A!5FM1:NT'7 3 V-I'D : 0t*' UI:* . SE V*'AR'7 PATI.-D:
ME.Z 7,:ANT NEi:7
,
FLOOP LOAD:: A14 I•F'1:PILK S PRI(I_1417 ALARM?
F•L.C)W((;PM) DET E C.""? Y1d"$
G)I.Art C:FdE C:l( SY: 1-,1.1.
GSE::MAG1K!:►
RI:;A:SSI.)E: OF NO . t',C 941
LAST I11-.T!5!51.)F:' 9901.75
F:El ►;�
O MtJR:.SISE T'TE: DON I. 1:::FTM'!'T 81�1'LF) . 00
W 1
E 1.►t► E311X :0952AFi-AN i�ll!i:V1:EW It,/I 0O
R 13 r3 r'61.ra►'►r1 t:►r• 1 L I DI:SP1
'T'AX If 2.0 . 90
O TI-IE:11 1 ;.:�0 . 0 0
C VE::L_01-'MEN'r
O M(JI•,T SSE:I VE" DDM C,(ST(JI-tM) $250 . 00
r: N
T I:)CIIJ HOPISSE.T 1 K 1:":•t.l.1. 1>I:R!:i L,, J(':(S TREIF:T 1 )O . OO
A MIX 50 . 00
C Nr.►r•L1.a►rl(l 431'• 19721.9 1: 1EPAID i '' ` . 00)
1:1-IONE t t`50 3) 24,1-931-1 k
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R r1F.I.I:riTl'2r"t'I'.T.(JN NC). 35533 TOTAL. : AM-4 O
or
This permit is issued subject to the regulations contrined in TI
of the TMC. State of Oregon Specialty Codes.zoninj re-
and all other applicable codes and ordinances, anrl
agreed that the work will be done in accordance wits r a i I'T 1'Nr; !:iECWE:1.
sp:►cifications and in compliance with all applic JUNDA'1'ION WAI...I... PAIN DPA119S
ordinances The issuance of this permit does no, )S'T 131:AM WATE::R Iw1:NE.
covenants. Contractor and subcontractors shall ke t .
business tax permits. This permit will expire and be 13.UNDE:RSI...AE3 ('.0 TY AP'7F1(.".H/5W
void if wor:(Is riot started wi.hin 180 day's,or if work is 5L.A8 171:NAI...
abandoned for a period of 180 days any time af„ Pl..13. 113POU T
commence all be the responsibility of the permittee 110—at..b FRAM 1:Nt:,
all reions are requested and apprn.ed.
F't:RE:r:,l..Ar:r:
(:,AS L. INV'.
1:N5 I.L A'r'1:(:)N
---- ------ - -- GYP1AF�U
Permittee ignature ,�. I
Issued By: C f� 'CJ
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
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`{Y �-- ----�— — MEC.:HANIC;AI... PERMa. 1
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arrOFTIVARDA1:1M:1:'T” N(a. Mk4:•i�,17'r.!,�.{ta
Cm ISSUED: 3/t2 2/819
COMMUNITY DEVELOPMENT DEPARTMENT I-�CT;Ci•(, la►N"T',Nt). 0901.76
13125 S.W.MNI BI id..P.O.Boa 23397,Tigard.Oregon 97223,(503)639-4175
,1(113 ADD{E.513: 1.2632 S:iW SOARIF.1. l: OCK GT
TAX MALS/LOT 1.51. -X-33-1.) 1.5000 511.04: FAJMMF;WLAI<E: I»1' :31.
LAND (ISE: R7Pn
I a'T SIZE-. �
1:'T'1=M: NO Cal 1
1 WC)RK CLASS : NEW F"I.JRNA(,E: (1-00K n'I:F1 FlraNr)I...F7 <'I.0
L)S E 'T'YP.".-::: SINGLE F:'AM.rI...Y FURNACE E 1.001(4• 1. AIR I••IAN1:)I.,R 1.0K
I CGNCi'T'.'T YPF-* : VN FLOOR I'-I.JPNA(';I::: F::.VAP.(::t7OL E 11 r
(7taa.lra .(314P . I• EA'TF::17 VI:.N1' IAN :3
} VIwN i VEN'T'. SYSTEM
I
{ F31...R/C(:)MI=, F•ICJt:)D i
ft NO. S"C(7Fl:rES : P F.A.RICOMP 3-,:1.:`.1-11P INC TNEWA•TIOR(DOM
4 OWF'.LL..UNI T'5i : t 1:NCINIERAT011111COM
1:L1Fi:l-. *T'YPE GA", 13L.R/f.:CJMf-! :30-•:101-II:) PI--'.PA7:R 1.1141•1'S
MAX . TNRLIT FA-P/CLOMP 30+HP OTI-if":141
I 'CRF:: 011PPS"/ CaAS C-11:I:)1:NC; OL)1Lri:T5 l
II:r.Cal•i r�1ar-55
d I
"W PRESS,
1 --
12F�.'MA)21Lci ' I
1
1
9
L-5
(
0 Ml)F2:rSGF,T,T1,-,. D014 1'FiI:2M'r'T' $1,0 00 `
2 W I:r13 BOX 1952/1 Pt AN 1:21::V:I:E::W 11i 1 0 . ::50
N laur•L1,lit 1-1 d err F I ftJ17Fi:S 4133 00
F
p 4:iIn L* TAX $R . 1.0
i t)T'Hk:F't
1
C
0 I31ca...1... I11KA'T :rNCa :I:N(:: ,
N
T 1.525t505E PIAZZA F'•rVri:
R
I, ..All:*AMA Si (')R 9- 70:1.5
C e4:5 1.1.FJra
11ti:C;?:=r'1'RA'1'1:ClN NO. 4-17 TOTAL. :T'AL. : * 54. h0
r�
Thisermit is issued subject to the regulations contained in Title 14 -.F -_.••.•• - -- - -
p GtFia;11J:1:12F::D I N.;hFaa'T(:)NS 1 _
q of the 1 Wi,.. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby (:SAS L.:I:NFi i
agreed that the work will be done in accordance with the plans and I!04S T Fih:AM ;
specifications and in compliance with all applicable codes and 1401.101-I--TN
ordinances The issuance of this permit does not waive restrictive
covenants. Contractor and subcontractors shall have current city
I" .I:NAI...
business tax permits This permit will expire and become null and
void if work is not started within 180 days.or if work is suspended or
8
5andoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all requir inspections are request approved
Perml Ignature
I`t:)R :1:11SyG:Ia:C:'1':I:C)N E�:317 /117«1
Issued Hy � __ — -------
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
...i. r •. -... �,..•w�w t�•" i*.prMY.-v...w�. zr-w- N„�.w... ..��+ .n, ± V�n ... i.y�ev.nryv
i
rte-- PI...UMBING: PEIZIMI'T
PEF KET Nth 90. . PL.132AI T
1"NOF TP—dox"A" LRYOin ARD I)ATE.: ISSUED '.''.1/22/89
COMMUNITY DEVELOPMENT DEPARTMENT offacm PRJ;M . PM'T .N(') . 8901*76
13125 S.W.HrN Blvd.,P.O.Box 23397,Tlgud,Oregon 97223.(503)6394175
.JZ,6:SLI SW !10I:)PI:I.,. UOCK ( T'
T'AX MAP/t..()'r 'I S:1 SAAE) V3000 SUB:: L..T::31 SK:
LAND USE:: P70)
LOT firzr.* :
NO: NO: ,
WOPK f.;1...ASS : NEW WA rEP CLOSE'T :5 'T RAF-'
USE: 'TYPE:: SINGLE:' FAM11. Y IINlNAI.. RI(FLOW P11VNT'14
C0N51' . 'I'YPk:: VN 1. AV(']RA'rl:)RY :.3 •1'NAP I'PXME:R
C)(::CLIP. (:)RF7 FUH !:1H(:)WE::FT r' (:;F1E:Ar3f.: 'T'htFiF�!i
DI!51AWASHE:P J.
(.,APBA(')Ic: DISI"OSAI... 1 j
Nn . wT OPTFS : WASI.-II.NC,•; MAC.ICLNE. 1.
DWELL .UNIT!•:, : I. I-ALINI)HY ')'1'•Tr'AY PL.I)G . I)RA:I:N (DTA
1-1...noW DPA].N
9 INK :i. "GEWE P (F"'r)
WA'T'F:p 1-11F.:A'rE D ]. !i'1'C1F7r3/RAIN tF'T' �.
CI'T I••If:CFi
RFMAiii1,,�:,
1
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h1fJFl:E!ii!:iE'r•1•E: DON F'E PM1,1 $13P . ''i0
i W Flu BOX 1.9524
a N Fscrr t].a►IId t.1r 1•'JXT'L.IF7E$
E
R15,rh,T,F." 'T'Ax *«6.6;3
j t:)'T'1•iE::F7
C HAINIL..1)
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N S11-11UEMAIKE"R' S PLUMPING
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T 1a13 BOX 11250
R 1w1:.;1. Fa cIm tar• 970.*-':x
A
C PHONE: (:30;3) 630••••f7'r:2(3
O RUC3TSTRA7TON NO :aniri3 T'C)T'AL.. . 'f 1.39 . 'I.3
R
FiECE:T P'T' NU .
_.._._._._.._......._.........,_...................
_ .w
This permit is issued subject to the rnquistions contained in Title 14
of the TMC State cl OreO^,Specialty Codes,zoning regulations Ith:6Il.1 CF'tl q :I:1NI1:1PE'C'T'1()1SI!
and all other applicable codes and ordi lances, and it is hereby PLB.UNE)E PSI..A8
agreed that the work will be done In accordance with the plans and Pl)E'i r & I:)Iii.AM
specifications and in compliance with all applicable codes and WA 1 E::F+ L.1NE:
ordinances. The issuance of Snis permit does not waive restrictive FSI 8 113MIL I'T'
eoverants. Contractor and subcontractors shall have current city
business tax permits.This permit will expire and become null and PA TN DPATNS
void if work Is not started within 180 days.or if work is suspended or F T NAl.
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required ins ions are requested an proved.
1/
Permittee Si re ;TE
Issued By —__ ftl 1 I OP TN.I1PI::,( '1 TON (,;351••••11:1. 7,5SEPAPERMITS REQUIRED FOR WORK OTHER THA14 DESCRIBED ABOVE
.
SEWEA4 PF.RM11
SE
PE-P11,111'r NO . A390249
�'�OFT167ARD rTYVLFS
COMMUNITY DEVELOPMENT DEPA00110M DATE ViSUED: 3/P-2/09
RTMENT C
13125 S.W.Hall Blvd..P.O.Box 23397.Tigard,Oregon 97223,(503)6394170
J00 ADOWF:":*!� . 1.263P 5W 'AMPI: I DO(',K G'V (.15 NIJM8P.;'.R: 0 3 71.
3AD 1.5000 5UB: MJMMFIV"11-61<1 �
1 Ax MAP/L.01 1.Lsi �3� LA': 31. SK :
I-AND 1471711)
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sF:c-rt.ON: 3.3 rwp: 1.is 1;4N('.;. J.w
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USE TYPE: SINGoL.E.' FAMILY
acqree-till t.la With lall. r-ul.evi aincl I'1(0qLI1iii.tJAII'l1% (:I-F the Uni-Fie.(:l
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DWEI I-ING LJN:E*T*"a t
NO. OF' 01 DOPS :1.
0 MO PT S G E Y'FE MON $35 . 00
W Ella 8OX 1.95P411 (.1ONNE(:','r:l:ON CHARGE*. $111.00 . 00
Nt. lar I 'I'Nl:;: 'TAP INSIAL.L. .
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D I HEW $360 . 00
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RECEIPT NO .
This permit is issued subject to the regulations contained in Title 14
of the TIVIC. State of Oregon Specialty Codes.zoning regulations
and all other applicable codes and ordinances, and it is hereby GAI! I..'I:NF::
agreed that the work will be done In accordance with the plans and POS- . REAM
specifications and in compliance with all applicable codes and -J:N
ordinances The issuance ol this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city r* 1NAL.
business tax permits This pmmlt will expire and become null and
void it work is r,-,',star!ed w'(hin 180 d;-,,i or if work is suspended or
abandoned for a period f 180 J It after work h.-s
."iv m
0' MR 80 Ih,m:r ittet9toassure
commenced )a the lespon it
all required n-pp ee all
d approved
Permittee Signstu I r,
Issued By 11 1... FOVI TINISPECTION
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
dam,
CITYOFTIVA F'l_AN CHECK APPLICATION
l PLAN CHECK /l1� _—•-
COMMUNITY DEVELOPMENT' DEPARTMENT'- / PERMIT N
13125 S.W Hall Blvd..P.O.Bon 23397,Tlgsrc1.01agm 97223,(503)639-4175 �` DATE ISSUED
JOB ADDRESS: 1 G 5 Z Lj SQ✓V(_ CLC IL C T -i AX MAP/LOT /3/- 314 /SdOp
SUB: tMt;iLl✓�I�' — LAND USE: — D
-�� LOT: --,�-
VALUATION:AIL _
OWNER I SPECIAL NOTES
MILLi
NAME: _ O 2 L�/ Cl 1 5 !���. REISSUE OF:
ADDRESS: d _ LAST REISSUE:
9 Icy _— FLOOD PLAIN/ � r
SENSITIVE LAND: T _
l APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: -` c�7 _ ENGINEERING:
ADDRESS: — FIRE DEPT
OTHER: f
PHONE: — —__ ITEMS REQUIRE U
— I._IST/SUBCONTRACTORS:
ARCH/ENGINEERBUS TAX:
NAME: --- ____ CALCUL.AT IONS:
ADDRESS: — _ TRUSS DETAILS: -
-� PARKING PIAN:
LANDSCAPE PLAN.
PHONE (-_-(—�— OTHER:�_ �_.�--
COMMENTS: �L� S_S UL' y ��_ G '�__..!7 I___
PERMIT N ACCT N DESCRIPTION AMOON-1 AMOUNT PD, DAL_. DUE.
10- 2 00 BuildingPermit Fees
10-431 00 Plumbing Permit Fees3?
.2 10-431 01 Mechanical Permit Fees _�2�" �Z.���
n 10-230 01 State Building Tax (576)
Building
Plumbing
10-433 00 Plans Check Fee �./j +�M
Building D f7o__ Go
Plumbing
Mech /0,Sv
b2y�i 30--202 00 Sewer Connection /ted v`D
?0--444 00 Sewer- Injpection ? .
51•-448 00 Street System Dev Charge (SDC) w
52--449 00 Parks System Dev Charlie (PDI;)
31-.450 00 Storm Drainage S;st Dev Chr•g (GSUC) _ v_. _......._.____ _._.AS.V..
10-230 09 I'RFD
10- 230 06 Washington County Fire N1 (9576)
10-22.0 00 Amart/Wedgewood
74
IOTAL
REC M
FiPPL.IC N (;NATURE __._ __._.______....W._..___......_.....
Received By: __......__ Date Received: _......__ Liz-
cn/3587P/18P